Advances in clinical management of eosinophilic esophagitis.
Advances in clinical management of eosinophilic esophagitis.
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DOI：
10.1053/j.gastro.2014.07.055
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发表时间：
2014-12
期刊：
影响因子：
29.4
通讯作者：
Liacouras CA
中科院分区：
文献类型：
--
作者：
Dellon ES;Liacouras CA
EoE是一种慢性免疫/抗原介导的临床病理疾病，在过去的20年里，它已经成为成人和儿童上消化道疾病日益重要的原因。它的诊断依据是食道功能障碍的症状，食道活检中存在至少15个嗜酸性粒细胞/高倍视野，以及排除引起食道嗜酸粒细胞增多的其他原因，包括质子泵抑制反应性食道嗜酸粒细胞增多症(PPI-REE)。我们回顾了我们最近所了解的EoE的临床方面，讨论了成人和儿童EoE的临床、内窥镜和组织学特征。我们解释了目前的诊断标准和诊断面临的挑战，包括胃食道反流病和PPI-REE的作用。还必须考虑EOE的流行病学(目前每年1/10,000新病例的发病率和每年0.5-1/1000病例的流行率)和疾病进展情况。我们回顾了主要的治疗方法和新的治疗选择；EoE可以用局部皮质类固醇治疗，如氟替卡松和布地奈德，或饮食策略，如基于氨基酸的配方，过敏试验定向消除饮食，和非定向经验性消除饮食。内窥镜扩张术也成为治疗EOE纤维狭窄并发症的重要手段。EoE中有许多未解决的问题，包括表型、最佳治疗终点、维持治疗的作用以及难治性EoE的治疗。EoE患者的护理和疾病研究跨越许多学科-EoE理想地由胃肠病专家、过敏症专家、病理学家和营养师组成的多学科团队进行管理。
EoE is a chronic immune/antigen-mediated clinicopathologic condition that has become an increasingly important cause of upper gastrointestinal morbidity in adults and children over the past 2 decades. It is diagnosed based on symptoms of esophageal dysfunction, the presence of at least 15 eosinophils/high-power field in esophageal biopsies, and exclusion of competing causes of esophageal eosinophilia, including proton pump inhibitor-responsive esophageal eosinophilia (PPI-REE). We review what we have recently learned about the clinical aspects of EoE, discussing the clinical, endoscopic, and histologic features of EoE in adults and children. We explain the current diagnostic criteria and challenges to diagnosis, including the role of gastroesophageal reflux disease and PPI-REE. It is also important to consider the epidemiology of EoE (current incidence of 1/10,000 new cases per year and prevalence of 0.5-1/1,000 cases per year) and disease progression. We review the main treatment approaches and new treatment options; EoE can be treated with topical corticosteroids such as fluticasone and budesonide, or dietary strategies, such as amino acid-based formulas, allergy test-directed elimination diets, and non-directed empiric elimination diets. Endoscopic dilation has also become an important tool for treatment of fibrostenostic complications of EoE. There are number of unresolved issues in EoE, including phenotypes, optimal treatment endpoints, the role of maintenance therapy, and treatment of refractory EoE. The care of patients with EoE and the study of the disease span many disciplines—EoE is ideally managed by a multidisciplinary team of gastroenterologists, allergists, pathologists, and dieticians.
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影响因子：
24.5
作者：
Cheng E;Zhang X;Huo X;Yu C;Zhang Q;Wang DH;Spechler SJ;Souza RF
通讯作者：
Souza RF
影响因子：
29.4
作者：
Butz BK;Wen T;Gleich GJ;Furuta GT;Spergel J;King E;Kramer RE;Collins MH;Stucke E;Mangeot C;Jackson WD;O'Gorman M;Abonia JP;Pentiuk S;Putnam PE;Rothenberg ME
通讯作者：
Rothenberg ME
影响因子：
24.5
作者：
Attwood, SEA;Lewis, CJ;Whittam, J
通讯作者：
Whittam, J
DOI：
10.1016/j.jaci.2010.10.039
发表时间：
2011-01
期刊：
The Journal of allergy and clinical immunology
影响因子：
--
作者：
Blanchard C;Stucke EM;Rodriguez-Jimenez B;Burwinkel K;Collins MH;Ahrens A;Alexander ES;Butz BK;Jameson SC;Kaul A;Franciosi JP;Kushner JP;Putnam PE;Abonia JP;Rothenberg ME
通讯作者：
Rothenberg ME
影响因子：
14.2
作者：
Assa'ad, Amal H.;Putnam, Philip E.;Rothenberg, Marc E.
通讯作者：
Rothenberg, Marc E.